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Venkata
Venkata
Diddi
Medical doctor
Brentwood, United States
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Florida Health Care Practitioner Data Portal
Full name
Venkata Diddi
Job Title
Medical Doctor
Location
Brentwood, TN, USA
LIC ID
142342
Current License Expiration Date
31/01/2025
Original Date
28/03/2019
Professional Rank Code
ME
Effective Date
28/03/2019
Board Action Indicator
N
License Status Description
CLEAR
License Active Status Description
ACTIVE
Country Description
Out of State
Mailing Address Line 2
Suite 110
Practice Location Address Line 1
5314 Maryland Way
Practice Location Address Line 2
Suite 110
Practice Location Address City
BRENTWOOD
Practice Location Address State
TN
Practice Location Address Zipcode
37027
Mode Code
NICA Exempt
Prescribing Indicator
N
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